Outcomes of social work and case management services during inpatient spinal cord injury rehabilitation: The SCIRehab project

Abstract

Objective

To investigate associations of social work/case management (SW/CM) services during inpatient rehabilitation following spinal cord injury (SCI) and patient characteristics with outcomes.

Design

Prospective observational cohort of individuals with SCI receiving inpatient rehabilitation.

Setting

Six inpatient rehabilitation centers.

Participants

1032 individuals with traumatic SCI.

Interventions

Not applicable.

Main outcome measure(s)

Type of residence at the time of rehabilitation discharge. Employment/school status, presence of a pressure ulcer, Patient History Questionnaire, Satisfaction with Life Scale, Craig Handicap Assessment and Reporting Technique (CHART) subscales, and rehospitalization at 1-year post-injury.

Results

The intensity of specific SW/CM services is associated with multiple outcomes examined. More sessions dedicated to discharge planning for a home discharge and financial planning were associated positively with more discharge to home, while more sessions focused on planning for discharge to a location other than home, e.g. nursing home or long-term acute care facilities, have negative associations with societal participation outcomes (CHART Social Integration, Occupation, and Mobility scores) as well as with residing at home at the time of the 1-year injury anniversary.

Conclusion(s)

The intensity and type of SW/CM services are associated with outcomes at rehabilitation discharge and at 1-year post-injury. Discharge to home may require assistance from SW/CM in the area of discharge planning and financial planning, while discharge to non-home residence demands directed SW/CM services for such placement.

Note

This is the eighth of nine articles of this SCIRehab series.

Keywords:

• Spinal cord injuries
• Rehabilitation
• Tetraplegia
• Paraplegia
• Patient discharge
• Social work
• Case management
• Participation
• Practice-based evidence
• Outcomes

Acknowledgements

This work was supported in part by grants from the National Institute on Disability and Rehabilitation Research (NIDRR), Office of Special Education Services, U.S. Department of Education to: Craig Hospital (grants H133A060103 and H133A060005), Carolinas Rehabilitation, Shepherd Center (Grant H133N060009), and Rehabilitation Institute of Chicago (grant H133N060014).